Right-left propensity and lesion patterns between cardiogenic and aortogenic cerebral embolisms

Stroke. 2011 Aug;42(8):2323-5. doi: 10.1161/STROKEAHA.111.616573. Epub 2011 Jun 9.

Abstract

Background and purpose: Based on thrombus location and nature and anatomic features of aorta and cerebral arteries, we hypothesized that cardiogenic embolisms (CE) and aortogenic embolisms (AE) might have different right-left propensity and lesion patterns.

Methods: We retrospectively reviewed patients with acute ischemic stroke with high-risk CE sources or moderate-or-severe aortic atherosclerotic plaques on transesophageal echocardiography. Lesion side and patterns on diffusion-weighted imaging were compared between CE and AE.

Results: CE was identified in 123 and AE in 63. In multivariate analysis, right-sided lesions and corticosubcortical infarcts were independently associated with CE, and left-sided lesions and pial infarcts were independently associated with AE.

Conclusions: CE and AE have different radiological characteristics, as shown by the right-left propensity and lesions patterns of cerebral infarcts.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aorta / pathology*
  • Brain / pathology*
  • Brain Ischemia / etiology
  • Brain Ischemia / pathology*
  • Diffusion Magnetic Resonance Imaging
  • Female
  • Humans
  • Intracranial Embolism / complications
  • Intracranial Embolism / pathology*
  • Male
  • Middle Aged
  • Plaque, Atherosclerotic / complications
  • Plaque, Atherosclerotic / pathology
  • Retrospective Studies
  • Stroke / etiology
  • Stroke / pathology*